The lack of email causes anguish to patients and their families as they wait in their front hall, morning after morning, for the snail-mail letter to come through the letterbox, bearing good or bad reports and announcing the dates of hospital appointments. When an email could have come the day before yesterday, or last week. Hospital administrators and clinicians do not see that anguish, so they do nothing about it.

I have done a straw poll of local and some major hospital websites to see whether any hospitals have shown any progress in the last three years towards entering the 21st century.

The answer is "not a lot". All give email addresses for their media and jobs departments. Some extend this to general enquiries, cancelling appointments, Freedom of Information requests and Patient Advice and Liaison Services.

The Royal Marsden provides an email form on the website to send messages to the hospital; Barts shows a standard forename-surname format for emailing anybody in the hospital; UCLH shows GPs how they, but not patients, can access different parts of the hospital by email. Cambridge University hospitals, like Barts, offers an email format, but goes further. It seems, uniquely, to have actually started thinking through an email strategy. The website says:

"The trust has in place a policy of obtaining patient consent either verbally or in writing before using email as a method of communication. This consent is either taken over the phone or face to face.If we receive an email from you and we do not have your consent to use your email address, we may contact you by telephone or by letter when responding to your enquiry.Some departments have listed their email contacts on this website – please do not misuse these or send junk mail because it distracts them from patient-focused work.Please don't send confidential information via email unless it is within the NHSnet only - this is an insecure route."

This all sounds rather bureaucratic, and seems to want to erect barriers rather than break them down, but it does at least show that Addenbrookes is prepared to countenance some of its patients actually contacting their doctor by email. Amazing. The big question of course is: will Oxford follow? Not according to the John Radcliffe website, which currently allows email only for the media and Pals.

Will the Cambridge initiative create a breakthrough across the country in 2012? I am sure there are already GPs who have been happily corresponding with their patients for years, and some hospital doctors who do the same. But I see no sign of any central initiative. When I fill in the usual questionnaire before any outpatients appointment, I am never asked for my email address. There is no King's Fund conference scheduled on the challenge of implementing email in the NHS. There, as far as I know, is no eager beaver in the DH wanting to make his name by outlawing snail mail.

The argument, three years ago, that only 50% of the population could access email no longer holds. Martha Lane Fox's Race Online report for November 2011 claimed that only 19% of the population is not on the internet. So, why should 81% of patients suffer because 19% are on the far side of the digital divide?

When I asked the chief executive of one of my local hospitals whether she was about to allow patient-doctor email, she gave me a look, and trotted out the same old-fashioned security arguments I used to hear three years ago. But e-security has moved on a lot in three years and, anyway, does she really think the Royal Mail is secure?

Last year, a survey of MPs found that as much as 60% of their constituency business was conducted by email. Are constituency matters any less secure than most correspondence between doctor and patient? MPs are renowned for their Luddism. I contend that medics are worse, and it is this that lies at the heart of their anti-email stance. They seem incapable of realising how much email would improve their connection with the patient, or how it could save the NHS millions of pounds.

They cannot be bothered to engage with the upsides of email, or with confronting the downsides.

With those two new ways of treating patients, there are at least substantial lobbies rooting for them. But, with email, the prospects are much worse. As far as I can see, there is no one pushing. We are still at first base. So, in 2012, all I see are individual chinks of light, but no general dispersal of the snail-mail fog, which still envelops the NHS in its icy grip.

About this article

When will the NHS start using email to contact patients?

This article was published on
the Guardian website
at 08.04 EST on Monday 23 January 2012.
It was last modified at 20.41 EDT on Tuesday 3 June 2014.
It was first published at 07.02 EST on Monday 23 January 2012.

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